Impact of chronic kidney insufficiency on the endothelial function of saphenous vein grafts in coronary artery bypass grafting

Lars Saemann (Halle (Saale))1, L. Wernstedt (Halle (Saale))1, S. Pohl (Halle (Saale))1, B. Hofmann (Halle (Saale))1, G. Veres (Halle (Saale))1, A. Simm (Halle (Saale))1, G. Szabó (Halle (Saale))1

1Universitätsklinikum Halle (Saale) Universitätsklinik und Poliklinik für Herzchirurgie Halle (Saale), Deutschland


Purpose: Saphenous vein grafts are the most frequently used conduits in coronary artery bypass grafting (CABG). An intact and functionally preserved endothelial layer in the graft is crucial for reestablishing myocardial perfusion. We hypothesized that comorbidities, such as chronic kidney insufficiency (CKI), decrease the endothelial function of saphenous vein bypass grafts.

Methods: In organ bath chambers, we prospectively investigated the maximal vasoconstriction to phenylephrine (PEmax), maximal endothelial-dependent relaxation to acetylcholine (RmaxACh), and maximal endothelial-independent relaxation to sodium-nitroprusside (RmaxSNP) in 26 consecutive CABG patients with CKI and 47 without CKI.

Results: Both groups were comparable regarding storage solution, sex, age, body weight, NYHA class, LVEF, the prevalence of arterial hypertension, adiposity, hyperlipoproteinemia, administering antiplatelet drugs, NOACs, and statins. However, type 2 diabetes was more prevalent in patients with CKI (62 vs 34%).

In patients with CKI, the endothelial-dependent RmaxACh was significantly impaired compared to patients without CKI (37 vs 50%; p<0.05). PEmax (with CKI: 160% vs without CKI: 168%; p>0.05) and the endothelial-independent RmaxSNP (100 vs 100%) were comparable between both groups.

Conclusions: The endothelial-dependent vasorelaxation in saphenous vein bypass grafts is impaired in CABG patients with CKI.

Diese Seite teilen